Journal of Musculoskeletal Trauma

Old Atlantoaxial Rotary Subluxation Associated with High-riding Vertebral Arteries: Arthrodesis Using C1 Lateral Mass Screws and C2 Laminar Screws: A Case Report: Kyeong Hwan Kim, Jin Sup Yeom, Kun Woo Park, Soon Woo Hong, Bong Soon Chang, Choon Ki Lee; J Korean Fract Soc 2007;20(1):90-93. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.90

To the best of our knowledge, there has been no domestic report on posterior atlantoaxial fusion with segmental screw fixation using C2 laminar screws and C1 lateral mass screws for atlantoaxial subluxation. We report the result of this operation performed in a patient with old atlantoaxial rotary subluxation who required posterior fusion. We chose this technique in this patient because wire fixation was not suitable due to osteoporosis, and transarticular screw fixation and use of C2 pedicle screws were not feasible due to the peculiar bony anatomy of the axis.

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Indirect Decompression using Segmental Screw Fixation for Cervical Myelopathy Caused by C1-2 Subluxation - Technical Note -
Yoon Jong Kim, Kyeong Hwan Kim, Jong Hwa Won, Hak Jin Min, Ui Seong Yoon, Jin Sup Yeom
The Journal of the Korean Orthopaedic Association.2007; 42(6): 815. CrossRef

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Comparison of Uniportal and Biportal Vertebroplasty in Bone Cement Distribution and Leakage: Jae Hyup Lee, Kang Sup Yoon, Seung Baik Kang, Hyunchul Jo, Sang Ki Lee, Bong Soon Chang, Choon Ki Lee, Ji Ho Lee; J Korean Fract Soc 2006;19(4):471-476. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.471

Abstract: PURPOSE
To evaluate the differences of radiological outcomes of uniportal and biportal vertebroplasty in the point of bone cement distribution and leakage.
MATERIALS AND METHODS
A retrospective study reviewing the period between May 2002 and January 2006 investigated 100 vertebrae which underwent vertebroplasty and followed for more than three months by uniportal approach (55 vertebrae, group 1) and biportal approach (45 vertebrae, group 2). The operative time, the amount of bone cement injected, anterior vertebral height restoration, kyphotic angle, bone cement distribution, and bone cement leakage were evaluated.
RESULTS
The amount of injected bone cement of group 1 (3.9 cc) was statistically smaller than that of group 2 (5.1 cc) (p=0.016). There were no significant differences in the operative time, anterior vertebral height restoration, kyphotic angle in both groups. The rate of bone cement distribution over 8 zones was significantly higher in group 2 than in group 1 (p=0.014). However, the rate of bone cement distribution over 7 zones and the rate of bone cement distributed on whole anterior vertebral body were not significantly different in both groups. The cement leakage was not also significantly different in both groups.
CONCLUSION
Although the amount of injected bone cement was smaller in uniportal vertebroplasty, the radiological results and cement leakage were similar to biportal vertebroplasty. These findings suggest that uniportal vertebroplasty can be the operative options in osteoporotic vertebral fracture.

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Evaluation of Osseointegration in Titanium Alloy Cortical Screws with the Passage of Time: Jae Hyup Lee, Bong Soon Chang, Choon Ki Lee; J Korean Fract Soc 2004;17(4):401-407. Published online October 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.4.401

Abstract PDF: PURPOSE
To evaluate the osseointegration of titanium alloy cortical screws with the passage of time.
MATERIALS AND METHODS
Fifty four titanium alloy cortical screws (24 mm in length, 3.5 mm in diameter) were implanted bilaterally in the tibial diaphysis of adult mongrel male dogs of similar size and weight (30 +/-5 kg). The insertion torques, radiographs, undecalcified histology, histomorphometric analysis and extraction torques were evaluated at 2, 4 and 8 weeks after surgery.
RESULTS
The extraction torque at 2 weeks (1.14+/-0.470 cN. m) was significantly lower than the insertion torque (1.76+/-0.609 cN. m) (p=0.0071), the extraction torque at 4 weeks (2.57+/-1.36 cN. m) was slightly improved and the extraction torque at 8 weeks (3.18+/-0.499 cN. m) was significantly higher than insertion torque (p=0.0005). Direct bony contact in the early phase was poor and intervening fibrous tissue was observed at the bone-screw interface. However, the fixation between the bone and the screws improved with time. The percentage of bone-screw contact at 8 weeks (33.1+/-18.5%) was higher than that of 2 weeks (22.4+/-12.9%), but not statistically significant.
CONCLUSION
Because of thermal injury or pressure necrosis, the fixation strength of titanium alloy cortical screws at 2 weeks after implantation is significantly lower than that at the insertion time. So, we should keep in mind the initial phase weakness of screw fixation when we allow the patients the range of motion exercise or weight bearing and the improvement of the initial phase fixation is very important in clinical results.

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Bioresorbable Implant Fixation for the Treatment of Radial Head and Neck Fractures: Coo Hyun Baek, Young Jin Sohn, Choon ki Lee, Moon Sang Chung; J Korean Soc Fract 1998;11(1):70-77. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.70

Abstract PDF: Between March 1988 and March 1995, 10 patients with displaced Mason type II, type III, or type IV fracture of the radial head or neck were treated by open reduction and internal fixation using bioresorbable pins. The average age of the patients was 38 years (22 to 70), and average follow-up period eas 14 months (12 to 18). There were 4 type II, 4 type III, and 2 type IV fractures. According to the functional rating system of Broberg and Morrey, the clinical results were reviewed at an average follow-up of 14 months. The functional results were 4 excellent, 5 good, and 1 fair. Fixation of displaced radial head or neck fracture using bioresorbable pins, was considered as one of the good methods.

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Analsis of the Distal Tibial Physeal and Epiphyseal Injury: In Ho Choi, Choon Ki Lee, Duk Yong Lee, Se Il Suk, Song Choi, Yong Hoon Kim, Suk Kee Tae, Seong Il Kim; J Korean Soc Fract 1989;2(2):164-173. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.164

Abstract PDF: We have reviewed 21 cases of physeal and epiphyseal fracture of the distal tibia including one case of juvenile Tillaux fracture and four cases of triplane fracture. The patterns of fracture were correlated with the mechanism of injury using the modified Lauge-Hansen method and sysemic classification of the triplane frature was proposed. Treatment included closed reduction and cast(9 cases), closed reduction and percutaneous pin fixation(4 cases), and open reduction(8 cases). Two of the nine patients treated by means of closed reduction and cast had ankle joint incongruity or progressive varus deformity requiring corrective ost eotomy. These two patients had either Salter-Harris Type III ro Type IV fracture after supination-inversion injury. In one patient, who had 100 per cent displacement of the distal tibial epiphysis and degloving injury of the ankle, premature physeal arrest developed after open reduction and internal fixaion for Salter-Harris Type Tyre I fracture. If there are triagular metaphseal ledge along with the juvenile Tillaux fracture-like vertical epiphyseal fracture line on the antero-posterior view and Salter-Harris Type II or Type IV frature on the lateral view, a certain type of triplane fracture is strongly suggested. Plain radiographs, however, could not accurately demontrate the detailed configuration of the triplane fracture, instead computerized axial tomography was very helpful us to analyse the true dimensions of the triplane fracture. We agree that displace Salter-Harri Type III or Type IV and transitional fractures with a fracture gap of more than two millimeters in the weight-bearing portion of the epiphysis regure open reduction.

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A Study of Classification of Ankle Fractures: Se Il Suk, Choon Ki Lee, Soo Ho Lee, Suk Kee Tae, Song Choi; J Korean Soc Fract 1989;2(2):155-163. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.155

Abstract PDF: Lauge-Hansens classification system and Webers classification system are the two most commonly used systems in ankle fractures. both are based on causative mechanism but both have some deficiencies. Authors intended to decide which is easily applicable in clinical practice and shwich provides more information about treatement, especially that of diastasis. So we analysed 143 cases of ankle fractures in Seoul National University Hospital, Kang-nam General Hospital and Namseoul Hospital from January 1983 to December 1988. The results obtained are as follows. 1. Webers type A fractures correspond not only supination-adduction but also to pronation-abduction and pronation-dorsiflexion. Type B fractures correspond most closely to supination-external rotation and possibly to pronation abduction and pronation external rotation. Type C fractures show the nearest equivalence to pronation-external rotation and occasionally correspond to supination-external roation or pronation-abduction. 2. Diastasis was noted in 16 cases(28%) of type B and in 18 cases(74%) of type C and this lower incidence was seemed to be due to neglect of diastasis at physical examination or during operation. 3. It seemed to be more reasonable to fix the diastasis with tibiofibular fixation screw especially in type C. 4. Webers simpler classification system, which can explain the hidden ligamentous injury such as diastasis, was more easily applicable in daily use than Lauge-Hansen classification.

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Treatment of Unstable Thoracic and Lumbar Spine Fracture with Harrington SSI(Segmental Spinal Instrumentation): Se IL Suk, Choon Ki Lee, Chong Suh Lee; J Korean Soc Fract 1988;1(1):54-63. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.54

Abstract PDF: This is a retrospective clinical and roentgenographic study to measure the correction of deformity and rigidity of Harrington SSI in the stabilization of unstable thoracic and lumbar spine fractures. 35 patients with unstable thoracic and lumbar spine fracture were treated with Harrington SSI from Feb. 1985 to Mar. 1987 in SNUH and 29 patients were followed up for more than 1 year, average 15.6 months. At final follow up of these 29 patients, 73.1% of patents gained neurologic improvment. Measurement of correction of anterior, middle and posterior coumn height, local kyphosis and anteroposterior offset were 29.7%, 5.2%, 31.2%, 12.8Â° and 5.3mm and loss of correction of these were 6.5%, 0.1%, 5.8%, 3.1Â° and 1.1m.

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